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[糖尿病性下肢动脉闭塞症患者中医辨证与血管内皮功能的关系]

[Relationship between syndrome differentiation of traditional Chinese medicine and vascular endothelial function in patients with diabetic arterial occlusion of lower extremities].

作者信息

Sun Lian-qing, Yang Yan, Zheng Wei

机构信息

Department of Peripheral Vascular Diseases, Affiliated Hospital, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province 250011, China.

出版信息

Zhong Xi Yi Jie He Xue Bao. 2007 Nov;5(6):621-4. doi: 10.3736/jcim20070604.

Abstract

OBJECTIVE

To investigate the relationship between syndrome differentiation of traditional Chinese medicine (TCM) and characteristic changes of vascular endothelial function in patients with diabetic arterial occlusion (DAO) of lower extremities.

METHODS

Forty patients with DAO were selected as trial group. Twenty patients among them were attributed to blood stasis syndrome (group A1), and the others were attributed to syndrome of pathogenic dampness-heat attacking the lower limb (group A2) according to syndrome differentiation type of TCM. Patients with diabetes (group B), arteriosclerosis obliterans (group C) and healthy people (group D) were observed as the control groups, respectively. There were 20 cases in each group. Endothelium-dependent dilation (EDD) and endothelium-independent dilation (EID) were measured by high resolution ultrasound in the 100 subjects and the changes of vascular tension factors were also studied.

RESULTS

The results showed that EDD in group A was reduced significantly as compared with that in the groups B, C and D. The levels of vascular contractile factors such as endothelin-1 (ET-1) and thromboxane B2 (TXB2) in group A were higher than those in the groups B, C and D, while the levels of vascular dilatory factors such as nitric oxide (NO) and 6-keto-prostaglandin F1alpha(6-Keto-PGF1alpha) were declined significantly as compared with those in the groups B and D. Linear correlation analysis showed that EDD was correlated positively with the levels of NO and 6-Keto-PGF1alpha, while the levels of ET-1 and TXB2 had negative correlation with EDD. EDD and EID in group A2 were declined significantly as compared with those in group A1.

CONCLUSION

Our findings indicate that endothelial dysfunction may play an important role in the pathogenesis of DAO and may be associated with syndrome differentiation of TCM.

摘要

目的

探讨下肢糖尿病性动脉闭塞症(DAO)患者的中医辨证与血管内皮功能特征性变化之间的关系。

方法

选取40例DAO患者作为试验组。根据中医辨证类型,其中20例归为血瘀证(A1组),其余归为湿热下注证(A2组)。分别选取糖尿病患者(B组)、动脉硬化闭塞症患者(C组)和健康人(D组)作为对照组,每组各20例。采用高分辨率超声检测100例受试者的内皮依赖性舒张功能(EDD)和非内皮依赖性舒张功能(EID),并研究血管张力因子的变化。

结果

结果显示,A组的EDD与B、C、D组相比显著降低。A组血管收缩因子如内皮素-1(ET-1)和血栓素B2(TXB2)的水平高于B、C、D组,而血管舒张因子如一氧化氮(NO)和6-酮-前列腺素F1α(6-Keto-PGF1α)的水平与B、D组相比显著下降。线性相关分析表明,EDD与NO和6-Keto-PGF1α的水平呈正相关,而ET-1和TXB2的水平与EDD呈负相关。A2组的EDD和EID与A1组相比显著下降。

结论

我们的研究结果表明,内皮功能障碍可能在DAO的发病机制中起重要作用,并且可能与中医辨证相关。

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